Devices, systems, and methods for adjustably tensioning an artificial chordae tendineae between a leaflet and a papillary muscle or heart wall

Abstract

The present disclosure relates generally to the field of medical devices for delivering artificial chordae tendineae in a patient. A system for adjusting tension in an artificial chordae tendineae includes an artificial chordae tendineae coupleable between a clip and an anchor. The clip is engageable with a leaflet of a heart valve while the anchor is engageable with a papillary muscle or heart wall. The anchor includes a body portion, and a locking portion coupleable with the artificial chordae tendineae and configured to allow movement of the artificial chordae tendineae in a first direction while preventing movement of the artificial chordae tendineae in a second direction opposite the first direction. An actuator is coupled to the locking portion for selectively releasing the locking portion to enable selective movement of the artificial chordae tendineae in the second direction.

What is claimed is: 
     
         1 . A system for adjusting tension in an artificial chordae tendineae, the system comprising:
 a clip engageable with a leaflet of a heart valve;   an anchor engageable with a papillary muscle or heart wall; and   an artificial chordae tendineae coupleable between said clip and said anchor;   wherein said anchor includes:   a body portion; and   a locking portion engageable with said artificial chordae tendineae and configured to allow movement of said artificial chordae tendineae in a first direction with respect to said body portion, while preventing movement of said artificial chordae tendineae in a second direction opposite the first direction;   said system further comprises an actuator coupled to said locking portion to move a portion of said locking portion in the first direction to enable selective movement of said artificial chordae tendineae in the second direction; and   wherein the actuator is a filament extending proximally to a user so that the user can activate said actuator to release said locking portion by pulling said actuator.   
     
     
         2 . The system of  claim 1 , wherein:
 said body portion defines a longitudinal slot therethrough, said artificial chordae tendineae extending through the slot; and   said locking portion comprises a locking element movable within the longitudinal slot in said body portion between a position contacting said artificial chordae tendineae to allow said artificial chordae tendineae to move in the first direction, and a position preventing said artificial chordae tendineae from moving in the second direction.   
     
     
         3 . The system of  claim 2 , wherein said locking element presses said artificial chordae tendineae against a wall of said body portion to prevent said artificial chordae tendineae from moving in the second direction. 
     
     
         4 . The system of  claim 1 , wherein said locking portion includes a locking element positioned with respect to said body portion and said artificial chordae tendineae to prevent movement of said artificial chordae tendineae in the second direction. 
     
     
         5 . The system of  claim 4 , wherein said locking element is movable in the first direction to allow movement of said artificial chordae tendineae with respect to said housing in the first direction. 
     
     
         6 . The system of  claim 4 , wherein said locking element is configured and positioned to press said artificial chordae tendineae into engagement with a portion of said body portion to prevent movement of said artificial chordae tendineae in the second direction. 
     
     
         7 . The system of  claim 1 , wherein said locking portion includes a locking element movable in the first direction with said artificial chordae tendineae to allow movement of said artificial chordae tendineae, and movable with said artificial chordae tendineae in the second direction to prevent further movement of said artificial chordae tendineae in the second direction. 
     
     
         8 . The system of  claim 1 , wherein said locking portion includes a locking element movable with respect to said body portion, and said actuator is coupled to said locking element of said locking portion. 
     
     
         9 . A device for adjusting tension in an artificial chordae tendineae, the device comprising:
 a body portion;   a locking portion configured and positioned with respect to said body portion to allow movement of an artificial chordae tendineae in a first direction with respect to said body portion, while preventing movement of the artificial chordae tendineae in a second direction opposite the first direction;   an actuator coupled to said locking portion to move a portion of said locking portion in the first direction to enable selective movement of the artificial chordae tendineae in the second direction; and   wherein the actuator is a filament extending proximally to a user so that the user can activate said actuator to release said locking portion by pulling said actuator.   
     
     
         10 . The device of  claim 9 , wherein:
 said body portion defines a longitudinal slot therethrough for passage of an artificial chordae tendineae therethrough; and   said locking portion further comprises a locking element movable within the longitudinal slot in said body portion between a position contacting an artificial chordae tendineae extending through the longitudinal slot to allow the artificial chordae tendineae to move in the first direction, and a position preventing the artificial chordae tendineae from moving in the second direction.   
     
     
         11 . The device of  claim 10 , wherein said locking element is positioned with respect to the longitudinal slot and said body portion to press an artificial chordae tendineae against a wall of said body portion to prevent the artificial chordae tendineae from moving in the second direction. 
     
     
         12 . The device of  claim 9 , wherein said locking portion includes a locking element positioned with respect to said body portion to prevent movement of an artificial chordae tendineae with respect to said body portion in the second direction. 
     
     
         13 . The device of  claim 12 , wherein said locking element is movable in the first direction to allow movement of an artificial chordae tendineae with respect to said housing in the first direction. 
     
     
         14 . The device of  claim 9 , wherein said locking portion includes a locking element movable with respect to said body portion, and said actuator is coupled to said locking element of said locking portion. 
     
     
         15 . A system for adjusting tension in an artificial chordae tendineae, the system comprising:
 a clip engageable with a leaflet of a heart valve;   an anchor engageable with a papillary muscle or heart wall; and   an artificial chordae tendineae disposed between the clip and the anchor;   wherein the anchor includes:
 a body portion, and 
 a locking portion engageable with the artificial chordae tendineae and configured to allow movement of the artificial chordae tendineae with respect to the body portion; 
   wherein the system further comprises an actuator coupled to the locking portion;   wherein the actuator is configured to shift the locking portion between an unlocked configuration where the artificial chordae is movable relative to the body portion and a locked configuration where the artificial chordae is substantially fixed relative to the body portion; and   wherein the actuator extends proximally to a user so that the user can activate the actuator by pulling the actuator.